There has been a rise of almost 40% rise in the number of staff working in children and young people’s mental health services, according to NHS data.

The workforce report for Health Education England revealed that there are 24,848 staff in total employed in CYPMH services across England, delivering a total of 20,626 whole time equivalent (WTE) staff across all sectors.

This position equates to a 39% growth on the 14,857 WTE staff reported in the previous census on 31st December 2018.

The vast majority of staff in CYPMH services (75%) are employed by the NHS and this workforce has seen a notable increase since 2019, with a 34% increase in headcount and a 40% increase in WTE. Most NHS employed staff are found in community CYPMH services (82%).

The second largest sector in terms of workforce size is the independent sector (2,293 WTE) who employ 11% of the total CYPMH staff reported in England. There are 1,497 WTE staff employed by the voluntary sector, which accounts for 7% of the total CYPMH workforce. The remaining 600 WTE staff are employed by local authorities which accounts for 3% of the workforce and 790 WTE staff are employed by Youth Offending Teams, accounting for 4%.

“The growth in the CYPMH workforce outlined in this report should be seen in the context of the low baseline for staffing that was identified in the first census in 2016. Since this point, CYPMH services have grown in response to accelerating demand for young people’s mental health care and the support of a range of national policy initiatives. The workforce growth now evident aligns with the concerted attempts to increase capacity that were outlined in the Five Year Forward View for Mental Health and the NHS Long Term Plan,” said the report.

The report explains that referrals into CYPMHS has more than doubled in the eight years from 2012/13, from 1,857 referrals received per 100,000 population (aged 0-18) to 3,872 per 100,000 population in 2019/20.

CYPMHS initially experienced a large reduction in referrals received during the early months of the Covid pandemic, with 53% fewer referrals received in April 2020 compared to pre-pandemic levels. The report attributes this reduction in referrals to difficulties in accessing primary care services and the closure of schools as national lockdowns were imposed across the UK.

In the period between March 2021 and July 2021, there was an influx of referrals made to CYPMHS as national lockdowns eased and schools re -opened. The rise in demand for CYPMH services provides clear background context for the increase in workforce size reported in the 2021 census.

The report reveals:

• Substantial growth in A&C staff (52% / 886 additional staff), this may reflect the enhanced need for these staff given increased referral volumes and increased focus on waiting times.
•  A notable increase in unregistered / support worker staff (54% / 626 additional WTE). This may translate to providers adopting affordable/recruitable nursing models playing through the system in response to the additional CCG investment.
• The growth in unregistered staff is most evident in inpatient care, but also evident to some extent in community services.
• Large increase in specific new roles, for example CYP education mental health practitioner and Children’s Wellbeing Practitioners.
• The growth in education practitioners reflects the growth of Mental Health Support Teams (MHSTs) in schools.
• Psychological therapists have risen sharply with an additional 521 WTE (32%). This growth may reflect supply factors in response to the increased CCG investment. Clinical psychologists are generally more available than registered nursing staff.
• Social Worker growth at +184 WTE / 51% is welcome and reflects the increased focus on CYP wellbeing / wider determinants of health in mainstream CYPMHS, and also perhaps a recognition of these needs from local authority/trust partnership vehicles.
• The fall in the “other” category, may indicate better data quality in the third cycle of the census.

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Overall, NHS Trusts have a median average of 161 CYPMH staff per Trust (headcount). This is 44% higher than the median of 112 reported in 2019 and supports the headline position that the NHS CYPMH workforce has grown by around 40% since 2019.

The report also revealed that a large majority of CYPMH services reported they provided Mental Health Support Teams (MHST) which are now almost as prevalent as CYPMH crisis and Eating Disorder teams. In inpatient services, the most commonly provided service was general CYPMH adolescent beds, followed by general CYPMH children’s beds. General admission beds are the most frequently provided bed type.

“The growth seen within the NHS workforce can be linked with an increase in funding for CYPMH within the Five Year Forward View and the NHS Long Term Plan strategies. Increase in CYPMH activity has been evident in recent years, with referrals doubling, CYP on caseload increasing, and a growth in the workforce, which suggests a sector that is expanding to cope with increasing demand. This trend was disrupted by the pandemic but recent evidence from 2021 confirms ongoing demand growth at levels not previously experienced,” the report concluded.

Children and Young People’s Mental Health Services Workforce Report for Health Education England